Individual provider Active NPI

Andrea Sofia Boneo

  • Student in an Organized Health Care Education/Training Program
  • San Juan, PR
National Provider Identifier
1104646926
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
6561687 Issued in PR
Practice address
10C Calle Casia
San Juan, PR 00921-3200
Phone
(787) 641-7582
NPI assigned
Oct 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 6561687 PR Primary

Addresses

Primary practice location

10C Calle Casia
San Juan, PR 00921-3200

Mailing address

520 Calle Jardin Dorado
Toa Alta, PR 00953-3642
Phone (787) 347-3170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6561687PRMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1104646926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CALLE JARDIN DORADO",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009533642",
            "telephone_number": "787-347-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10C CALLE CASIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEO",
        "first_name": "ANDREA",
        "middle_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "6561687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.